Fracture risk prediction in post-menopausal women with osteopenia and osteoporosis: preliminary findings

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"documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Enferm Clin. 2018;28 Supl 1:227-31" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 459 "formatos" => array:3 [ "EPUB" => 54 "HTML" => 274 "PDF" => 131 ] ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Family support and maternal self-efficacy of adolescent mothers" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "227" "paginaFinal" => "231" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jehan Puspasari, Imami Nur Rachmawati, Tri Budiati" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Jehan" "apellidos" => "Puspasari" ] 1 => array:2 [ "nombre" => "Imami" "apellidos" => "Nur Rachmawati" ] 2 => array:2 [ "nombre" => "Tri" "apellidos" => "Budiati" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862118300731?idApp=UINPBA00004N" "url" => "/11308621/00000028000000S1/v4_201810090949/S1130862118300731/v4_201810090949/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "titulo" => "Fracture risk prediction in post-menopausal women with osteopenia and osteoporosis: preliminary findings" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "232" "paginaFinal" => "235" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Nik Noor Kaussar Nik Mohd Hatta, Muhammad Lokman, Mohd Said N, Azlina Daud, Muhammad Ibrahim, Mohd Ariff Sharifudin, Samsul Deraman" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Nik Noor Kaussar" "apellidos" => "Nik Mohd Hatta" "email" => array:1 [ 0 => "kaussar@iium.edu.my" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Muhammad" "apellidos" => "Lokman" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Mohd" "apellidos" => "Said N" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Azlina" "apellidos" => "Daud" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Muhammad" "apellidos" => "Ibrahim" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Mohd Ariff" "apellidos" => "Sharifudin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 6 => array:3 [ "nombre" => "Samsul" "apellidos" => "Deraman" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Kulliyyah of Nursing, International Islamic University of Malaysia (IIUM), Kuantan Campus, Pahang, Malaysia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Kulliyyah of Allied Health Science, International Islamic University of Malaysia (IIUM), Kuantan Campus, Pahang, Malaysia" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Kulliyyah of Medicine, International Islamic University of Malaysia (IIUM), Kuantan Campus, Pahang, Malaysia" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 767 "Ancho" => 903 "Tamanyo" => 36640 ] ] "descripcion" => array:1 [ "en" => "Correlation between year of menopause and the FRAX major osteoporotic fracture risk score." ] ] ] "textoCompleto" => "IntroductionOsteopenia and osteoporosis are conditions of metabolic bone disorders. According to the World Health Organization (WHO), osteoporosis in post-menopausal women is defined as bone mineral density (BMD) T scores ≤ –2.5 of the young adult mean<a class="elsevierStyleCrossRef" href="#bib0005">1</a>, and osteopenia, or low bone density, is defined as BMD T score between –1.0 SD and –2.5 SD. These conditions are known as primary osteoporosis as they occur among the elderly and post-menopausal women<a class="elsevierStyleCrossRef" href="#bib0010">2</a>,<a class="elsevierStyleCrossRef" href="#bib0015">3</a>. The risk of osteoporosis and osteopenia increases as people age. Recent findings have shown that progressive fracture risk is correlated with advancing age<a class="elsevierStyleCrossRef" href="#bib0020">4</a>.This silent disease is alarming for post-menopausal women because no specific sign or symptom is evident before the occurrence of fracture. Fragility fracture is a nightmare to all post-menopausal women because it leads to serious complications and even death.Approximately one in every three women over the age of 50 years will encounter a fragility fracture throughout her life<a class="elsevierStyleCrossRef" href="#bib0025">5</a>. About 61% of fragility fractures occurs in women, with female to male ratio of 1.6<a class="elsevierStyleCrossRef" href="#bib0030">6</a>. Hip fractures among Malaysians above the age of 60 between June 2008 and December 2009 predominantly occurred in females. Majority (82.5%) of these women were post-menopausal at the time of the fracture<a class="elsevierStyleCrossRef" href="#bib0035">7</a>. The high incidence of osteoporotic fractures among elderly suggests that it is a significant cause of morbidity and mortality<a class="elsevierStyleCrossRef" href="#bib0040">8</a>. Therefore, proper prevention and treatment in approaching this problem is essential. Nowadays, significant developments have occurred in the pharmacotherapy of osteoporosis and efficacious treatments to reduce the risk of fractures. These developments have substantially improved the management of patients with osteoporosis. Unfortunately, the risk of fragility fractures is not yet eliminated because there are still unmet needs requiring a broader range of therapeutic<a class="elsevierStyleCrossRef" href="#bib0045">9</a> and preventive steps.The prediction of fracture risk is one of the valuable tools in calculating the 10-year probability of obtaining a major fracture and hip fracture<a class="elsevierStyleCrossRef" href="#bib0050">10</a>. The incidence of fragility fracture as a major cause of disability, poor quality of life and mortality can be reduced by the proper assessment of fracture risk. FRAX score is a new fracture risk assessment tool (FRAX®) that is widely used in determining a 10-year prediction for possible fractures, and it is recommended by the WHO Collaborating Center for Metabolic Bone Diseases in Sheffield, United Kingdom. This tool includes clinical data and bone mineral density measured by dual-energy X-ray absorptiometry<a class="elsevierStyleCrossRef" href="#bib0055">11</a>. Aside from providing a 10-year probability of obtaining fracture, this tool can assist in identifying those who are at the greatest risk of fracture, which can be detected early to aid in planning immediate preventive measures. At the same time, it can support clinical decision making in fracture risk management to reduce fracture-related disability, costs, and mortality. This study aims to identify the fracture risk prediction in post-menopausal women with osteopenia and osteoporosis. We present the preliminary findings of an ongoing research on the development of health education package in preventing fracture among post-menopausal women in Kuantan, Malaysia.MethodThis study applied a cross-sectional method involving 87 respondents from the orthopedic and menopause clinics of Hospital Tengku Ampuan Afzan Kuantan, Pahang, Malaysia, between April 2016 and October 2016. A purposive sample of the respondents’ age of 50 and above and post-menopausal women was utilized. The criteria in selecting respondents were based on the BMD result of the osteopenic range (T-score of less than −1 and greater than −2.5 SD). Data collection was performed after obtaining approval from the Research Ethics Committee of the International Islamic University and National Medical Research Registry. The respondents were evaluated using a questionnaire on various independent risk factors for osteoporosis, including parental hip fractures, previous fractures, current cigarette smoking habit, glucocorticosteroid usage, alcohol consumption, rheumatoid arthritis, caffeinated drinks, and years of menopause. Physical examinations included weight and height measurement using the BC541 Innerscan Body Composition Scale Tanita and the Body Scale M-400 (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>The WHO fracture risk assessment tool (FRAX®) was used to calculate the risk for major and hip fracture probability in 10 years’ time. The selection of an appropriate country for the FRAX tool was conducted because no FRAX tool was available for the Malaysian population. In the absence of a FRAX® model for a specific country, a surrogate country is chosen based on the likelihood that it is a representative of the index country in terms of life expectancy and fracture incidence<a class="elsevierStyleCrossRef" href="#bib0050">10</a>. Therefore, the calculation for Singapore was chosen because the population comprised of three major races (Malay, Indian, and Chinese) similar to the ethnic distribution in Malaysia. FRAX® is a computer-based algorithm developed by the WHO Collaborating Center for Metabolic Bone Diseases and was first released in 2008<a class="elsevierStyleCrossRef" href="#bib0060">12</a>.Descriptive data were generated for all the variables. The Pearson correlation test was conducted to determine the relationship between the independent variables and the FRAX 10-year probability of fracture. Correlation was considered significant at a p value < 0.05. Data management and analysis were performed using SPSS version 20.0 (2011).ResultsOut of the 87 post-menopausal women recruited, 50.6% were osteopenic and nearly half (48.3%) had osteoporosis (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>). The mean age of the respondents was 61.6 years old (SD=7.9). Among the respondents, 34 were Malay and 46 were Chinese. The mean year of menopause of the respondents was 11.9 (SD=8.5), ranging from 1 to 44 years. The FRAX findings indicated a 9.7% major osteoporotic fracture probability and a 3.5% hip fracture probability, which were denoted as high risk (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> presents the fracture risk factors of the respondents. More than 80% of the respondents had none of the risk factors, thus indicating that they were not at risk for fracture. Majority (80.5%) of the respondents had no previous fractures. A positive family history (having parents with hip fracture) was observed in 16.1% of the respondents.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>The Pearson correlation coefficient showed a significant positive but weak correlation between year of menopause and FRAX major osteoporotic and hip fracture probability (r=0.581, p < 0.001) and (r=0.495, p < 0.001), as shown in <a class="elsevierStyleCrossRef" href="#fig0010">Figures 2</a> and <a class="elsevierStyleCrossRef" href="#fig0015">3</a>.<elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia>DiscussionPrevious studies reported a higher risk of fractures among women than men, with post-menopausal women living a sedentary lifestyle being the most affected<a class="elsevierStyleCrossRef" href="#bib0055">11</a>,<a class="elsevierStyleCrossRef" href="#bib0065">13</a>. The present study found a 9.7% major osteoporotic fracture probability and a 3.5% of hip fracture probability, which both indicate a high risk for hip fracture based on the age intervention threshold for Malaysia adopted by the Malaysian Osteoporosis Society (MOS)<a class="elsevierStyleCrossRef" href="#bib0070">14</a>, as revealed by the FRAX findings. MOS utilized a threshold probability of 20% for major osteoporotic fracture and 3% for hip fracture probability. The risk score of 3.5% for hip fracture among post-menopausal wom-en in this study indicates that this population is at a high risk of obtaining a hip fracture in 10 years’ time. There is increasing concern that a considerable number of research findings have revealed an exponential increment of hip frac-ture incidences<a class="elsevierStyleCrossRef" href="#bib0035">7</a>,<a class="elsevierStyleCrossRef" href="#bib0075">15</a>. This study highlighted the importance of fracture risk assessment among post-menopausal women for the early detection of fracture risk and thus the prevention of fragility fracture.The correlation between years of menopause and the probability of major osteoporotic and hip fractures is among the remarkable findings of the present study. The pathogenesis of osteoporosis in women involves augmented bone resorption by osteoclasts in relation to changes in the estrogen levels at menopause. The increase in bone resorption appears to be the most important stimulus for bone loss in the situation of acute estrogen deficiency that occurs in menopausal women<a class="elsevierStyleCrossRef" href="#bib0080">16</a>. Osteoblasts, osteocytes, and osteoclasts express functional estrogen receptors<a class="elsevierStyleCrossRef" href="#bib0085">17</a>. Deficiency in estrogen increases bone resorption and impairs bone formation, thus leading to bone loss. This information is essential in understanding why the risk of osteoporosis and fragility fracture exponentially increases with years of menopause. Therefore, the present study strongly recommends the use of a fracture risk assessment to identify the common factors related to fracture risks with or without bone density results among post-menopausal women as early preventive measures. The early detection of the risk factors will provide the post-menopausal population the knowledge required to prevent fragility fractures." "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:3 [ "identificador" => "xres1092631" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1035503" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Method" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 5 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "xack371210" "titulo" => "Acknowledgement" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1035503" "palabras" => array:5 [ 0 => "Post-menopausal women" 1 => "Fracture risk prediction" 2 => "FRAX" 3 => "Osteopenia" 4 => "Osteoporosis" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveThe study aims to identify the risk of obtaining a fracture among post-menopausal women with osteopenia and osteoporosis. MethodThis work was a cross-sectional study involving a purposive sample of 87 post-menopausal women who attended the orthopedic and menopause clinics of Hospital Tengku Ampuan Afzan, Kuantan. The data were entered into the WHO fracture risk assessment tool (FRAX®) to predict major fracture and risk for hip fracture in 10 years’ time. ResultsThe mean age of the respondents was 61.6 years (SD=7.9). Among the respondents, 50.6% had osteopenia and nearly half (48.3%) had osteoporosis. The mean number of menopausal years of the respondents was 11.9 (SD=8.5), ranging between 1 and 44 years. The FRAX findings indicated 9.7% major osteoporotic fracture probability and 3.5% hip fracture probability, which were denoted as high risk. A Pearson correlation coefficient was computed to assess the relationship between menopausal years and the FRAX major osteoporotic fracture probability. A significant positive correlation was found between the two, but the correlation was weak (r=0.581, n=87, p < 0.001). ConclusionsThe present findings indicate that menopausal years have a positive correlation with the risk of obtaining a fracture." 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menopause and the FRAX major osteoporotic fracture risk score." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 739 "Ancho" => 953 "Tamanyo" => 38646 ] ] "descripcion" => array:1 [ "en" => "Correlation between year of menopause and the FRAX hip fracture risk score." ] ] 3 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Name \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Date of birth \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Body weight \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Body height \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">BMI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Years of menopause \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Previous fracture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Parental hip fracture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Smoker \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Glucocorticosteroid usage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Rheumatoid arthritis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Alcohol consumption (3 or more units/day) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Caffeinated drinks (3 or more cups/day) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1868581.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Questionnaire." ] ] 4 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col">N=87 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col">n (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col">Mean ± SD \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61.2 ± 7.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Year of menopause \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.9 ± 8.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top">FRAX 10-year risk score</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Major osteoporotic fracture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.7% ± 7.7% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hip fracture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.5% ± 3.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top">Race</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Malay \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34 (39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Chinese \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46 (52.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Indian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (5.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Others \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1868580.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Characteristic of the participants and the FRAX risk scores." ] ] 5 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N=87 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Yes \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">No \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Previous fracture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (19.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">70 (80.5%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Parental hip fracture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 (16.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">73 (83.9%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Rheumatoid arthritis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (9.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">79 (90.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Alcohol consumption \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">— \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">87 (100%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Glucocorticosteroid usage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (6.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">81 (93.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Smoking \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (1.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">86 (98.9%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Caffeinated drinks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 (32.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59 (67.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1868582.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Fracture risk factor." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:17 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "WHO scientific group on the assessment of osteoporosis at primary health care level: summary meeting report, Brussels, Belgium, 5-7 May 2004." ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => 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"fecha" => "2014 Jul" "volumen" => "142" "paginaInicial" => "155" "paginaFinal" => "170" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24176761" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Disorders of bone remodeling" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "X. Feng" 1 => "J.M. McDonald" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1146/annurev-pathol-011110-130203" "Revista" => array:6 [ "tituloSerie" => "Annu Rev Pathol." 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Nik Noor Kaussar Nik Mohd Hattaa,

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kaussar@iium.edu.my

Corresponding author.

, Muhammad Lokmana, Mohd Said Na, Azlina Dauda, Muhammad Ibrahimb, Mohd Ariff Sharifudinc, Samsul Deramanc

a Kulliyyah of Nursing, International Islamic University of Malaysia (IIUM), Kuantan Campus, Pahang, Malaysia

b Kulliyyah of Allied Health Science, International Islamic University of Malaysia (IIUM), Kuantan Campus, Pahang, Malaysia

c Kulliyyah of Medicine, International Islamic University of Malaysia (IIUM), Kuantan Campus, Pahang, Malaysia

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Osteopenia and osteoporosis are conditions of metabolic bone disorders&#46; According to the World Health Organization &#40;WHO&#41;&#44; osteoporosis in post-menopausal women is defined as bone mineral density &#40;BMD&#41; T scores &#8804; &#8211;2&#46;5 of the young adult mean<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#44; and osteopenia&#44; or low bone density&#44; is defined as BMD T score between &#8211;1&#46;0 SD and &#8211;2&#46;5 SD&#46; These conditions are known as primary osteoporosis as they occur among the elderly and post-menopausal women<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; The risk of osteoporosis and osteopenia increases as people age&#46; Recent findings have shown that progressive fracture risk is correlated with advancing age<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46;This silent disease is alarming for post-menopausal women because no specific sign or symptom is evident before the occurrence of fracture&#46; Fragility fracture is a nightmare to all post-menopausal women because it leads to serious complications and even death&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Approximately one in every three women over the age of 50 years will encounter a fragility fracture throughout her life<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#46; About 61&#37; of fragility fractures occurs in women&#44; with female to male ratio of 1&#46;6<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#46; Hip fractures among Malaysians above the age of 60 between June 2008 and December 2009 predominantly occurred in females&#46; Majority &#40;82&#46;5&#37;&#41; of these women were post-menopausal at the time of the fracture<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46; The high incidence of osteoporotic fractures among elderly suggests that it is a significant cause of morbidity and mortality<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#46; Therefore&#44; proper prevention and treatment in approaching this problem is essential&#46; Nowadays&#44; significant developments have occurred in the pharmacotherapy of osteoporosis and efficacious treatments to reduce the risk of fractures&#46; These developments have substantially improved the management of patients with osteoporosis&#46; Unfortunately&#44; the risk of fragility fractures is not yet eliminated because there are still unmet needs requiring a broader range of therapeutic<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> and preventive steps&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The prediction of fracture risk is one of the valuable tools in calculating the 10-year probability of obtaining a major fracture and hip fracture<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&#46; The incidence of fragility fracture as a major cause of disability&#44; poor quality of life and mortality can be reduced by the proper assessment of fracture risk&#46; FRAX score is a new fracture risk assessment tool &#40;FRAX<span class="elsevierStyleSup">&#174;</span>&#41; that is widely used in determining a 10-year prediction for possible fractures&#44; and it is recommended by the WHO Collaborating Center for Metabolic Bone Diseases in Sheffield&#44; United Kingdom&#46; This tool includes clinical data and bone mineral density measured by dual-energy X-ray absorptiometry<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46; Aside from providing a 10-year probability of obtaining fracture&#44; this tool can assist in identifying those who are at the greatest risk of fracture&#44; which can be detected early to aid in planning immediate preventive measures&#46; At the same time&#44; it can support clinical decision making in fracture risk management to reduce fracture-related disability&#44; costs&#44; and mortality&#46; This study aims to identify the fracture risk prediction in post-menopausal women with osteopenia and osteoporosis&#46; We present the preliminary findings of an ongoing research on the development of health education package in preventing fracture among post-menopausal women in Kuantan&#44; Malaysia&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Method</span><p id="par0020" class="elsevierStylePara elsevierViewall">This study applied a cross-sectional method involving 87 respondents from the orthopedic and menopause clinics of Hospital Tengku Ampuan Afzan Kuantan&#44; Pahang&#44; Malaysia&#44; between April 2016 and October 2016&#46; A purposive sample of the respondents&#8217; age of 50 and above and post-menopausal women was utilized&#46; The criteria in selecting respondents were based on the BMD result of the osteopenic range &#40;T-score of less than &#8722;1 and greater than &#8722;2&#46;5 SD&#41;&#46; Data collection was performed after obtaining approval from the Research Ethics Committee of the International Islamic University and National Medical Research Registry&#46; The respondents were evaluated using a questionnaire on various independent risk factors for osteoporosis&#44; including parental hip fractures&#44; previous fractures&#44; current cigarette smoking habit&#44; glucocorticosteroid usage&#44; alcohol consumption&#44; rheumatoid arthritis&#44; caffeinated drinks&#44; and years of menopause&#46; Physical examinations included weight and height measurement using the BC541 Innerscan Body Composition Scale Tanita and the Body Scale M-400 &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The WHO fracture risk assessment tool &#40;FRAX<span class="elsevierStyleSup">&#174;</span>&#41; was used to calculate the risk for major and hip fracture probability in 10 years&#8217; time&#46; The selection of an appropriate country for the FRAX tool was conducted because no FRAX tool was available for the Malaysian population&#46; In the absence of a FRAX<span class="elsevierStyleSup">&#174;</span> model for a specific country&#44; a surrogate country is chosen based on the likelihood that it is a representative of the index country in terms of life expectancy and fracture incidence<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&#46; Therefore&#44; the calculation for Singapore was chosen because the population comprised of three major races &#40;Malay&#44; Indian&#44; and Chinese&#41; similar to the ethnic distribution in Malaysia&#46; FRAX<span class="elsevierStyleSup">&#174;</span> is a computer-based algorithm developed by the WHO Collaborating Center for Metabolic Bone Diseases and was first released in 2008<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Descriptive data were generated for all the variables&#46; The Pearson correlation test was conducted to determine the relationship between the independent variables and the FRAX 10-year probability of fracture&#46; Correlation was considered significant at a p value &#60; 0&#46;05&#46; Data management and analysis were performed using SPSS version 20&#46;0 &#40;2011&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="par0035" class="elsevierStylePara elsevierViewall">Out of the 87 post-menopausal women recruited&#44; 50&#46;6&#37; were osteopenic and nearly half &#40;48&#46;3&#37;&#41; had osteoporosis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; The mean age of the respondents was 61&#46;6 years old &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#46;9&#41;&#46; Among the respondents&#44; 34 were Malay and 46 were Chinese&#46; The mean year of menopause of the respondents was 11&#46;9 &#40;SD&#61;8&#46;5&#41;&#44; ranging from 1 to 44 years&#46; The FRAX findings indicated a 9&#46;7&#37; major osteoporotic fracture probability and a 3&#46;5&#37; hip fracture probability&#44; which were denoted as high risk &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> presents the fracture risk factors of the respondents&#46; More than 80&#37; of the respondents had none of the risk factors&#44; thus indicating that they were not at risk for fracture&#46; Majority &#40;80&#46;5&#37;&#41; of the respondents had no previous fractures&#46; A positive family history &#40;having parents with hip fracture&#41; was observed in 16&#46;1&#37; of the respondents&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The Pearson correlation coefficient showed a significant positive but weak correlation between year of menopause and FRAX major osteoporotic and hip fracture probability &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;581&#44; p &#60; 0&#46;001&#41; and &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;495&#44; p &#60; 0&#46;001&#41;&#44; as shown in <a class="elsevierStyleCrossRef" href="#fig0010">Figures 2</a> and <a class="elsevierStyleCrossRef" href="#fig0015">3</a>&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discussion</span><p id="par0050" class="elsevierStylePara elsevierViewall">Previous studies reported a higher risk of fractures among women than men&#44; with post-menopausal women living a sedentary lifestyle being the most affected<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&#46; The present study found a 9&#46;7&#37; major osteoporotic fracture probability and a 3&#46;5&#37; of hip fracture probability&#44; which both indicate a high risk for hip fracture based on the age intervention threshold for Malaysia adopted by the Malaysian Osteoporosis Society &#40;MOS&#41;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#44; as revealed by the FRAX findings&#46; MOS utilized a threshold probability of 20&#37; for major osteoporotic fracture and 3&#37; for hip fracture probability&#46; The risk score of 3&#46;5&#37; for hip fracture among post-menopausal wom-en in this study indicates that this population is at a high risk of obtaining a hip fracture in 10 years&#8217; time&#46; There is increasing concern that a considerable number of research findings have revealed an exponential increment of hip frac-ture incidences<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#46; This study highlighted the importance of fracture risk assessment among post-menopausal women for the early detection of fracture risk and thus the prevention of fragility fracture&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The correlation between years of menopause and the probability of major osteoporotic and hip fractures is among the remarkable findings of the present study&#46; The pathogenesis of osteoporosis in women involves augmented bone resorption by osteoclasts in relation to changes in the estrogen levels at menopause&#46; The increase in bone resorption appears to be the most important stimulus for bone loss in the situation of acute estrogen deficiency that occurs in menopausal women<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#46; Osteoblasts&#44; osteocytes&#44; and osteoclasts express functional estrogen receptors<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#46; Deficiency in estrogen increases bone resorption and impairs bone formation&#44; thus leading to bone loss&#46; This information is essential in understanding why the risk of osteoporosis and fragility fracture exponentially increases with years of menopause&#46; Therefore&#44; the present study strongly recommends the use of a fracture risk assessment to identify the common factors related to fracture risks with or without bone density results among post-menopausal women as early preventive measures&#46; The early detection of the risk factors will provide the post-menopausal population the knowledge required to prevent fragility fractures&#46;</p></span></span>"
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          "titulo" => "Introduction"
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          "titulo" => "Acknowledgement"
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        7 => array:1 [
          "titulo" => "References"
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    "PalabrasClave" => array:1 [
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          "clase" => "keyword"
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            0 => "Post-menopausal women"
            1 => "Fracture risk prediction"
            2 => "FRAX"
            3 => "Osteopenia"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The study aims to identify the risk of obtaining a fracture among post-menopausal women with osteopenia and osteoporosis&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This work was a cross-sectional study involving a purposive sample of 87 post-menopausal women who attended the orthopedic and menopause clinics of Hospital Tengku Ampuan Afzan&#44; Kuantan&#46; The data were entered into the WHO fracture risk assessment tool &#40;FRAX<span class="elsevierStyleSup">&#174;</span>&#41; to predict major fracture and risk for hip fracture in 10 years&#8217; time&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The mean age of the respondents was 61&#46;6 years &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#46;9&#41;&#46; Among the respondents&#44; 50&#46;6&#37; had osteopenia and nearly half &#40;48&#46;3&#37;&#41; had osteoporosis&#46; The mean number of menopausal years of the respondents was 11&#46;9 &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#46;5&#41;&#44; ranging between 1 and 44 years&#46; The FRAX findings indicated 9&#46;7&#37; major osteoporotic fracture probability and 3&#46;5&#37; hip fracture probability&#44; which were denoted as high risk&#46; A Pearson correlation coefficient was computed to assess the relationship between menopausal years and the FRAX major osteoporotic fracture probability&#46; A significant positive correlation was found between the two&#44; but the correlation was weak &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;581&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>87&#44; p &#60; 0&#46;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The present findings indicate that menopausal years have a positive correlation with the risk of obtaining a fracture&#46;</p></span>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Name&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Date of birth&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Body weight&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Body height&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">BMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Years of menopause&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Previous fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Parental hip fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Smoker&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Glucocorticosteroid usage&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Rheumatoid arthritis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Alcohol consumption &#40;3 or more units&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col">Mean &#177; SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Age</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#46;2 &#177; 7&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Year of menopause</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;9 &#177; 8&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">FRAX 10-year risk score</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Major osteoporotic fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;7&#37; &#177; 7&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hip fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;5&#37; &#177; 3&#46;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Race</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Malay&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Indian&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Fracture risk factor&#46;</p>"
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Article information

ISSN: 11308621
Original language: English

DOI:10.1016/S1130-8621(18)30074-3

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	5	3	8
2024 October	63	16	79
2024 September	80	21	101
2024 August	61	14	75
2024 July	58	10	68
2024 June	44	15	59
2024 May	64	5	69
2024 April	65	8	73
2024 March	58	14	72
2024 February	54	5	59
2024 January	79	5	84
2023 December	65	8	73
2023 November	64	4	68
2023 October	88	10	98
2023 September	66	13	79
2023 August	55	3	58
2023 July	91	2	93
2023 June	76	6	82
2023 May	72	5	77
2023 April	76	8	84
2023 March	79	10	89
2023 February	61	17	78
2023 January	55	2	57
2022 December	36	11	47
2022 November	32	15	47
2022 October	30	8	38
2022 September	31	7	38
2022 August	38	7	45
2022 July	47	8	55
2022 June	37	7	44
2022 May	34	9	43
2022 April	35	18	53
2022 March	79	20	99
2022 February	34	8	42
2022 January	45	11	56
2021 December	48	17	65
2021 November	46	17	63
2021 October	64	15	79
2021 September	47	11	58
2021 August	45	5	50
2021 July	43	9	52
2021 June	49	7	56
2021 May	26	8	34
2021 April	56	20	76
2021 March	42	16	58
2021 February	32	6	38
2021 January	23	18	41
2020 December	16	15	31
2020 November	25	19	44
2020 October	16	11	27
2020 September	22	15	37
2020 August	35	15	50
2020 July	18	9	27
2020 June	20	10	30
2020 May	15	16	31
2020 April	22	7	29
2020 March	28	10	38
2020 February	37	25	62
2020 January	40	21	61
2019 December	34	7	41
2019 November	23	8	31
2019 October	38	27	65
2019 September	21	11	32
2019 August	9	2	11
2019 July	21	4	25
2019 June	30	15	45
2019 May	32	2	34
2019 April	5	9	14
2018 December	2	1	3
2018 November	1	0	1
2018 April	1	0	1

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